Antineoplastic Agents ; therapeutic use ; Colorectal Neoplasms ; drug therapy ; genetics ; metabolism ; Genes, ras ; genetics ; Humans ; Lung Neoplasms ; drug therapy ; genetics ; metabolism ; Molecular Targeted Therapy ; methods ; Mutation ; Neoplasms ; drug therapy ; genetics ; metabolism ; Pancreatic Neoplasms ; drug therapy ; genetics ; metabolism ; Proto-Oncogene Proteins ; genetics ; metabolism ; Proto-Oncogene Proteins p21(ras) ; Receptor, Epidermal Growth Factor ; drug effects ; metabolism ; Signal Transduction ; ras Proteins ; genetics ; metabolism

Objective To evaluate the changes of platelet aggregation rate and short-term prognosis after the application of colopidgrel with booster doses or replaced by ticagrelor for ACS patients with CYP2C19 medium-metabolized genotype). Method A total of 302 patients with medium-metabolized genotype were randomly divided into colopidgrel group (75 mg/bid) and ticagrelor group (90 mg/bid). Patients in both groups accepted other conventional treatments of coronary heart disease and accompanied diseases. The platelet aggregation rates and platelet inhibition rates were observed before and after the treatment. The incidence of adverse events was followed up within 1 m. Results After one-week treatment, the platelet aggregation rates of the inducement with 5 μmol/L ADP had statistical significance between colopidgrel group and ticagrelor group ( P = 0 . 019 ) and the platelet inhibition rates had statistical significance difference between the two groups (P = 0.000). No severe adverse events occurred within one-month follow-up and 10 dyspnea patients were all in ticagrelor group. Conclusions Compared with booster doses of clopidogrel, ticagrelor presents obvious inhibitory effect on platelet of patients with medium-metabolized of ACS but it increases the incidence of dyspnea.

While the number of the enrolled postgraduate students is continuously increased and the various reforms go in depth, there appear some new problems and contradictions in the education of doctorial students.Among those problems,the lack of the doctorial student resource,especially the lack of the excellent doctorial student resource,is the most prominent problem that re- stricts the progress of the doctorial student education.In order to solve these problems,this article analyzes the factors influencing the resource of the students and put forward the strategy to deal with these factors.

Objective To compare the clinical analysis of alone or combined with antibiotics on community acquired pneumonia (CAP) in pediatric patients,and provide reference for clinical rational use of antibiotics.Methods The clinical data of 274 cases of CAP children treated by single antibiotic therapy and 271 cases of CAP children treated by bivalent antibiotic therapy were retrospectively analyzed,and the drug efficacy and adverse reactions were compared between the two groups.Results There were no statistical differences on the sex,age distribution and severity between the two groups (all P ＞ 0.05) ; The sputum submission rate in two groups were over 90％,and there were no significant differences on the positive rate and detection rate of multi-resistant bacteria (P ＞ 0.05) ; Treatment efficiency in the two groups of children were 97.45％ (267/274) and 98.15％ (266/271),the difference was not statistically significant (x2 =0.32,P ＞0.05) ; Average hospital inpatient days were (8.76 ± 1.75) d and (8.66 ± 1.62) d in the two groups,the difference was not statistically significant (x2 =0.71,P ＞ 0.05).Adverse reactions in the two groups of children mainly were drug fever,rash,nausea,bloating,hemolytic anemia.Cases of drug fever (50) and hemolytic anemia(32) in single antimicrobial group were significantly less than those in the combined with antibiotic group (51,72,x2 =4.804 and x2 =5.381,all P ＜0.05).Conclusion The effects of alone or combined with antibiotics on community acquired pneumonia in pediatric patients are same,so alone antibiotics is recommended for treating mild CAP to get better efficacy.

Background Choroidal melanoma(CM)is a common form of primary ocular cancer in adults.It is reported that indomethacin has inhibitory effect on many tumor in vitro and in vivo,but whether it can inhibit the growth of CM has not been published. Objective This study was to investigate the anti-tumor activity of indomethacin on the growth of human CM OCM-1 cell xenografts in nude mice. Methods OCM-1 cells were subcutaneously implanted on 24 SPF female BALB/C.nu/nu nude mice to establish ectopic models of human CM.The nude mice with the tumor 5 mm were randomly divided into 4 groups:untreated group,normal saline solution(NS) group,indomethacin 1 ms/kg group,indomethacin 2 ms/kg group.The 1 mS/kg or 2 ms/kg indomethacin was intraperitoneally injected for 14 consecutive days in indomethacin 1 ms/kg group and indomethacin 2 me/kg group respectively.and 0.2 ml of 2%NS-DMSO was used at a same way in the NS group.No any agent was used as the untreated group.The volume and weight of implanted tumor as well as inhibitory rates of indomethaein on tumor were calculated.The expression of ki67 and survivin proteins were measured with immunohistochemistry,and the expression of survivin mRNA in CM was assessed by RT-PCR. ResuIts The tumor of indomethacin treatment group was reduced in volume and weight with a significant difference between treatment group and control group as well as indomethacin 1 ms/ks group and indomethacin 2 ms/kg group(P＜0.05).The inhibitory rate of indomethacin 1 ms/kg and 2 ms/kg for tumor was 22.86%,48.00%respectively.The prolifiration index (PI)of ki67 in these 4 groups were (76.73±3.34)%,(73.30±2.95)%,(55.97±2.24)%,(32.87±2.91)%respectively,and significant difference was found in PI between indomethacin 2 mg/kg group and untreated group or NS group(P＜0.05),but there was not significant difference between indomethacin 1 mg/kg and 2 ms/kg group(P＞0.05).Compared with the control group,the indomethacin treatment groups showed the decreased expression of survivin protein and mRNA,and significant difference was found between indomethaein 2 ms/kg group and untreated group or NS group(P＜0.05),however,no significant difference was found between indomethacin 1 mg/kg and 2 mg/kg group(P＞0.05). Conclusion Indomethacin inhibits the growth of CM in nude mice through inhibiting the expression of survivin in the tumor and accelerating cell apoptosis and inhibiting tumor cell proliferation.

Adult ; Aged ; Amylases ; metabolism ; Diarrhea ; blood ; enzymology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Single-Blind Method

Objective To investigate the clinical efficacy of sequential plasma perfusion of low dose plasma exchange in the pa-tients with acute on chronic liver failure (ACLF).Methods The patients with HBV related ACLF in the infection department of the Affiliated Hospital of Luzhou Medical College were divided into the plasma exchange therapy group (group A,n=114)and the low dose plasma exchange sequential plasma perfusion therapy group (group B,n=144).The group A was treated only by plasma exchange of fresh frozen plasma 2 400 mL;while the group B adopted the sequential plasma perfusion of plasma exchange,with fresh frozen plasma dosage of 1 400 mL.The changes of the liver and renal function,coagulation function and electrolyte indicators were observed in the two groups.The differences in the clinical effects and adverse reactions were compared between the two groups.Results The serum levels of ALT,TBIL and INR after treatment in the two groups were significant decreased than before treatment(P<0.05);ALB and PTA were significantly improved compared with before treatment(P<0.05);there were no signif-icant differences in serum levels of CRE,K+ and Na+ between before and after treatment.The changes of various indexes before and after treatment had no statistical differences between the two groups.The total effective rate and the mortality at 24 weeks in the group B was 66.66% and 47.22% respectively,which had no statistical differences compared with the group A.The total oc-currence rate of adverse reactions in the group B was 23.75%,which was significant lower than 35.26% in the group A with statis-tical difference (P=0.011).Conclusion Sequential plasma perfusion of plasma exchange has better clinical effect and few adverse reactions for treating the patients with ACLF,which can reduce the plasma dosage significantly.

Automatic Data Processing ; Data Mining ; Humans ; Medicine, Chinese Traditional ; methods

Objective To explore somatic symptoms of patients with functional dyspepsia (FD) and effects of combined anti somatisation therapy on the quality of life in patients with FD.Methods Two hundred and nineteen patients with FD were enrolled.Patient Health Questionnaire-15 (PHQ-15) and Nepean Dyspepsia Index (NDI) were completed,and the relation between them was analyzed.Lansoprazole,mosapride and flupentixol melitracen (the anti-somatisation medication) were taken for four weeks by 131 FD patients who had poor response to four-week conventional treatment with proton pump inhibitors (PPI) and/or prokinetic medication and who got more than 4 scores in PHQ 15.And then therapeutic effects were observed and the changes of NDI before and after treatment were analyzed.The t test,chi-square test,Spearman's correlation and linear regression were performed for statistical analysis.Results The total PHQ-15 and NDI score of 219 patients with FD were 5.7±3.4 and 42.0± 10.4,and there was positive correlation between them (r=0.493,P＜0.05).Stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder,thirst and so on were positively correlated with totalNDIscore (r=0.262,0.230,0.241,0.243,0.352,0.385,0.266,0.281,all P＜0.05).Chest pain,stomach pain,shortness of breath,dizziness and fatigue were the influence factors of NDI (t=2.340,2.488,5.278,2.167,2.443,all P＜0.05).Among 131 patients with FD who received anti somatisation combination therapy,six patients did not complete the therapy because of the side effects,and finally 125 patients were enrolled and analyzed.Before and four weeks after the treatment,the total PHQ-15 scores of 125 patients with FD were 7.3±3.2 and 2.9±2.2,respectively; and the difference was statistically significant (t =12.653,P＜0.01).There were significant differences in the influence of stomach pain,headache,chest pain,dizziness,shortness of breath,fatigue,sleeping disorder and thirst before and after the treatment (not bothered at all,bothered a little,bothered a lot) (x2=39.231,6.796,6.693,15.520,6.698,51.572,44.390 and 16.506,all P＜0.05).The total NDI score before and after the treatment were 44.3 ± 11.7 and 29.2 ± 6.9,and the difference was statistically significant (t=12.503,P＜0.01).Conclusions The quality of life in patients with FD is affected by somatic symptoms such as chest pain,stomach pain,shortness of breath,dizziness,fatigue and so on.For FD patients with poor response to conventional treatment,the quality of life could be improved by the combination of anti-somatisation therapy and the conventional therapy.

Objective To compare magnetization transfer and diffusion characteristics of multiple sclerosis(MS)lesions,normal-appearing white matter(NAWM)from patients,and normal white matter from control subjects,and to investigate the correlation between the magnetization transfer ratio(MTR)and mean diffusivity(MD)in MS patients.Methods Conventional MRI,magnetization transfer imaging(MTI)and diffusion tensor imaging(DTI)were performed in 24 relapsing remitting MS patients and 24 healthy volunteers.Based on these images,the MTR,MD and fractional anisotropy(FA)maps were obtained.Then the MTR,MD and FA values were measured in lesions and NAWM from patients,and in the relevant white matter regions from volunteers.Results Average MTR in lesions(23.49%?5.16%)from MS patients was lower than those both in NAWM(29.49%?3.38%)and in the counterparts of the controls(32.78%?3.42%,F=101.44,P